Organization Active NPI

Valentini Therapy LLC

  • Adult Mental Health Clinic/Center
  • Wheaton, IL
National Provider Identifier
1568969780
Registry record updated Apr 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
071-006131 Issued in IL
Legal business name
VALENTINI THERAPY LLC
Practice address
400 W Roosevelt Rd
Wheaton, IL 60187-2329
Phone
(630) 632-5158
NPI assigned
Apr 13, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Concordia Valentini, PSYD
Title
Clinical Psychologist
Phone
(630) 632-5158

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 071-006131 IL Primary

Addresses

Primary practice location

400 W Roosevelt Rd
Wheaton, IL 60187-2329

Mailing address

1020 E Kenilworth Ave
Lombard, IL 60148-3146
Phone (630) 632-5158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180620000488 IL Part B Supplier - Clinic/Group Practice 3072868892 Receives reassigned benefits from 1 practitioner
Practice locations: Wheaton, IL

National Provider Directory

National Provider Directory

Locations

400 W Roosevelt Rd
Wheaton, IL 60187
Phone (630) 632-5158

400 W Roosevelt Rd
Ste 230
Wheaton, IL 60187
Phone (630) 632-5158

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523577600000",
    "number": "1568969780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 E KENILWORTH AVE",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601483146",
            "telephone_number": "630-632-5158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W ROOSEVELT RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601872329",
            "telephone_number": "630-632-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALENTINI THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-13",
        "last_updated": "2018-04-13",
        "status": "A",
        "authorized_official_last_name": "VALENTINI",
        "authorized_official_first_name": "CONCORDIA",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "630-632-5158",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "IL",
            "license": "071-006131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.